When Postpartum Depression Shows Up as Intense Anger

“After delivery, there’s this incredible change in reproductive hormones,” Katherine L. Wisner, MD, the Norman and Helen Asher Professor of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology at Northwestern’s Feinberg School of Medicine, tells SELF. “Hormones—such as estrogen and progesterone—go from the highest they’ll ever be down to almost nothing as soon as the placenta is delivered.” And some experts believe these rapid hormonal shifts are linked to the development of PPD in people who are biologically susceptible. 

Plus, recovering from a vaginal delivery or a C-section is hard and can be incredibly painful. Giving birth does not always go smoothly, and some estimates suggest one-third of people who give birth experience some form of trauma while delivering their baby, which may contribute to PPD or post-traumatic stress disorder (PTSD). While trauma can include things like enduring premature labor or feeling worried about a baby’s well-being, many people report that the people in the room—their care providers, including doctors, midwives, and nurses—are responsible for these distressing experiences, say, by dismissing the severity of a birthing parent’s pain, among many other scenarios.

But one of the biggest changes that will affect your day-to-day functioning as a new parent is the ability to get enough sleep. Recovering postpartum with little to no sleep is a challenge that’s underestimated by society, Dr. Wisner says. And, as you might be able to guess, studies have shown a strong correlation between sleep deprivation and emotions like depression, anxiety, and anger.

In a Canadian study of nearly 300 women, published in BMC Pregnancy and Childbirth in 2022, 31% of moms reported feeling intense anger, while more than half said their sleep quality was poor. The researchers concluded that a parent’s sleep quality, as well as feeling angry about their infant’s sleep quality, were two major predictors of postpartum anger. 

A range of disparities also contributes to the rage.

For Black birthing parents, in particular, the stigma anger carries can be a huge barrier to seeking necessary mental health support. “Anger and rage are widely under-recognized. There’s a natural shying away of emotions in fear of being the stereotype of the ‘Angry Black Woman,’” Lauren Elliott, the CEO and founder of Candlelit Therapy, a perinatal mental health care service for underserved new and expectant parents, tells SELF. “Black maternal health is in extreme crisis.”

There are a host of systemic issues that prevent Black people and other people of color from receiving proper mental health care. Birth parents of color experience higher-than-average rates of postpartum depression, and yet, they are less likely to be diagnosed, less likely to know that the symptoms they’re experiencing are related to PPD, and are therefore less likely to be properly treated, according to a report from the Center for American Progress.

“Black women are less likely to be screened in pregnancy for depression and anxiety,” Elliott says. The consequences of these disparities can be devastating. As SELF previously reported, Black and Indigenous women are two to three times more likely to die from pregnancy-related causes than white women, per the Centers for Disease Control and Prevention (CDC).